The mining workforce is potentially exposed to skin hazards that range from air conditioners to solvents, chemicals, minerals, mining dust and other substances; these hazards can result in a variety of skin conditions, including both allergic contact dermatitis (ACD) and irritant contact dermatitis (ICD), among other disorders. In the present study, the records of patients referred to the National Institute for Occupational Health (NIOH) occupational skin disease clinic from the mines between the years 2010 to 2023 were analysed. Of the 142 records retrieved, nine were excluded and a total of 133 were included in the study. Microsoft Excel was used for analysis. The median age of the participant workers was 39 years; workers within the age range 30-39 years were more commonly referred to the NIOH (35%) and the majority of workers were male (87%; 116/133). Platinum mines accounted for most of the workers (64%), followed by coal mines (13%). Atopy was reported in 28.6% of the workers; ICD accounted for 41% of the occupational skin disease (OSD) diagnoses, followed by ACD (32%). Metals accounted for 41% of the contactants, with mine dust accounting for 30% and explosives for 29% of them. Hands were the most common primary site for reactions (33%), followed by arms at 18%. The majority (98%) of the workers reported the use of personal protective equipment (PPE) such as rubber boots, gloves, masks or respirators. The European Standard Series (ESS) of patches was the most frequently used patch-test series (62%) in this study. The commonest allergens detected were nickel sulphate at 13%, with the second commonest being potassium dichromate (at 9%). Although occupational health measures have been put in place, the mining environment contains multiple irritants and allergens which can cause OSD; therefore, it is important to identify the cause of the OSD or to determine whether the skin disease is not occupation-related. This study highlights the value of patch-testing in the diagnosis of OSD among mine workers. Patch-testing was found to help with diagnosis by identifying an allergic cause of the OSD, particularly among workers exposed to various substances (both allergens and irritants). Patch-testing is an integral part of the assessment of OSD and should be considered in the assessment of workers exposed to various substances in the workplace, such as the mining industry.
The principle of beneficence means doing good. It refers to putting patients' interests before that of the healthcare professional (HCP) provided that no extreme sacrifice is required. For HCPs in particular, beneficence means providing the best treatment possible to our patients and acquiring the knowledge and clinical skills necessary to do so. Paternalism, on the other hand, is the intentional overriding of one person's known preferences or actions by another person, where the person who overrides justifies their action by appealing to the goal of benefitting the person or of preventing or mitigating harm to the person whose preferences or actions are overridden. Beneficence is not absolute and it is constrained by the principles of respect for autonomy, non-maleficence and justice.
Background: Globally, an estimated 17% of asthma in adults, could be attributed to the work environment and therefore be preventable. Work-related asthma (WRA), a preventable yet significant occupational health concern, has received limited attention among pharmaceutical workers despite the sector's economic importance. This highlights the importance of workers' having adequate knowledge of and a positive attitude to WRA. Objective: To assess the knowledge of and attitudes to WRA among pharmaceutical workers in Johannesburg. Methods: A quantitative cross-sectional study was conducted among 322 workers with various roles in Johannesburg's pharmaceutical industry. Data were collected electronically using a structured questionnaire and analysed using descriptive statistics and logistic regression models, which were adjusted for age and sex. Results: Pharmaceutical workers with 20-30 years of service had a significantly higher WRA knowledge than those with less experience (ORA = 4.29, 95% CI: 1.23-14.92). Atopic workers were more knowledgeable about the risks of WRA than non-atopic workers (ORA 27.30, 95% CI11.02-67.61). Workers who reported being 'very often' exposed to drug fumes had significantly higher unadjusted odds of WRA knowledge compared to those who reported 'never' being exposed (OR = 3.93, 95% CI: 1.31-11.79). Similarly, workers who were always exposed to preservatives (OR = 4.58, 95% CI: 1.58-13.39) and latex (OR = 12.30, 95% CI:5.09-23.25) were also more knowledgeable about WRA than those less exposed to them. Smokers had better attitudes to WRAthan non-smokers (OR = 2.66, 95% CI1.25-5.68). Conclusion: Factors such as work experience, smoking status and atopy affected pharmaceutical workers' knowledge of and attitudes to WRA. Work experience was associated with improved knowledge, suggesting the value of cumulative experience and targeted training. The findings highlight the need to strengthen education and training interventions to improve knowledge and awareness of WRA among all workers. These findings may contribute to advancing occupational health practices by promoting safer work environments and mitigating the burden of WRA in the pharmaceutical sector.
Oral corticosteroids (OCS) have been integral to the treatment of acute asthma exacerbations and severe difficult-to-control asthma for the past 6 decades. As asthma is a potentially life-threatening disease, the over-prescription of OCS is common. Recent studies show that life-time exposure to OCS of > 1 000 mg prednisolone-equivalent carries serious side effects and results in adverse outcomes. There is therefore an urgent need for corticosteroid (CS) stewardship in asthma and a concomitant emphasis on other strategies to mitigate over-exposure to corticosteroids. Individuals and professional societies have an important role to play in educating healthcare professionals, patients and the general public about the dangers of OCS.
